Our Summary

This study looks at how liver biopsies were performed on patients with a condition called Fontan-associated liver disease (FALD), which occurs in individuals who had the Fontan procedure - a type of heart surgery. The researchers performed the biopsies using two methods - transfemoral-transcaval (TFTC) and transjugular (TJLB).

The study looked at 30 procedures performed between August 2011 and May 2023. Of these, 23 were transfemoral and 7 were transjugular. All the biopsies were successful, meaning they accurately targeted the liver and safely obtained tissue samples. Most of the biopsies (93%) were performed at the same time as a heart procedure called cardiac catheterization.

The study found that, following the biopsies, there was no significant change in patients’ blood counts or the time it took to perform the procedures. However, there was one major complication in the group who had the transjugular method and one minor complication in the group who had the transfemoral method.

The researchers concluded that both methods of liver biopsy can be safely performed on FALD patients and provide accurate diagnoses. They prefer the transfemoral method as it can be done alongside cardiac catheterization and potentially avoids complications related to the Fontan shunt - a tube that helps direct blood flow in patients who have had the Fontan procedure.

FAQs

  1. What methods were used to perform liver biopsies in the study?
  2. What were the results and complications of the liver biopsies performed in the study?
  3. Why do researchers prefer the transfemoral method for liver biopsies on FALD patients?

Doctor’s Tip

One helpful tip a doctor might tell a patient about liver biopsy is to follow any pre-procedure instructions carefully, such as fasting before the procedure or stopping certain medications. It is also important to discuss any concerns or questions with your doctor beforehand and to make sure you understand the risks and benefits of the procedure. After the biopsy, it is important to follow any post-procedure instructions, such as avoiding heavy lifting or intense physical activity for a certain period of time. It is also important to monitor for any signs of complications, such as excessive bleeding or infection, and to contact your doctor if you experience any unusual symptoms.

Suitable For

Patients who are typically recommended for a liver biopsy include those with suspected liver disease, abnormal liver function tests, liver tumors, hepatitis, cirrhosis, fatty liver disease, autoimmune liver diseases, and monitoring of liver transplant patients. In the case of Fontan-associated liver disease, patients who have had the Fontan procedure and are showing signs of liver dysfunction or disease may be recommended for a liver biopsy to assess the extent of liver damage and guide treatment decisions.

Timeline

Before the liver biopsy:

  • The patient is informed about the procedure and its risks and benefits.
  • The patient may undergo blood tests and imaging studies to assess the liver.
  • The patient may need to fast before the procedure.
  • The patient may receive sedation or anesthesia to help them relax during the procedure.

After the liver biopsy:

  • The patient may experience some discomfort or pain at the biopsy site.
  • The patient may need to lie on their right side for a few hours to help prevent bleeding.
  • The patient may need to avoid strenuous activities for a few days.
  • The patient may need to follow up with their healthcare provider to discuss the biopsy results and any further treatment options.

What to Ask Your Doctor

Some questions a patient should ask their doctor about liver biopsy include:

  1. Why do I need a liver biopsy?
  2. What are the risks associated with a liver biopsy?
  3. What type of anesthesia will be used during the procedure?
  4. How long will the procedure take?
  5. Will I need to stay in the hospital after the biopsy?
  6. How will I feel after the biopsy? Will I experience any pain or discomfort?
  7. How soon will I receive the results of the biopsy?
  8. What will the biopsy results tell us about my condition?
  9. What follow-up care or treatment may be necessary based on the biopsy results?
  10. Are there any specific instructions I need to follow before or after the biopsy procedure?

Reference

Authors: Shahid MU, Frenkel Y, Kuc N, Golowa Y, Cynamon J. Journal: Cardiovasc Intervent Radiol. 2024 Jul;47(7):875-882. doi: 10.1007/s00270-024-03761-6. Epub 2024 May 30. PMID: 38816503